James Throt MBBS, MD, PhD, FRCPath Profile picture
Mar 5 17 tweets 3 min read Read on X
As a neurologist, I’ve dealt with Frontotemporal Dementia (FTD) patients for years

I often pondered how diabolical it would be if a world leader suffered the same fate

Now I’m seeing it play out in real time

Without impeachment, this will get darker than you could ever imagine
Frontotemporal dementia attacks the frontal lobes. The brain’s command center for judgment, empathy, impulse control, moral reasoning and long-term planning.

Imagine a world leader whose frontal lobes progressively fail, but no one intervenes.

Or worse, they cheer it on.
As FTD progresses, disinhibition dominates.

The leader may issue impulsive orders, make erratic public statements or flout norms & laws.

Even in those who were previously unmalicious, there would be a genuine neurological inability to foresee consequences.
Empathy erodes.

Decisions that would once horrify a morally intact leader; targeting vulnerable populations, ignoring human suffering, prioritising personal gain over collective safety etc start to feel trivial.

Imagine this in a leader who wasn’t morally intact to begin with.
Judgment collapses.

Strategic foresight, risk assessment, ethical reasoning and tactical nous are replaced with short-term, self-referential thinking.

Allies will soon be alienated, enemies emboldened, and crises mismanaged.
FTD often induces compulsive behaviours.

Obsession with trivialities, repetitive announcements, rigid black or white thinking, and fixation on symbolic victories over substantive problems.

Everything becomes increasingly theatrical.
Language may falter.

In some FTD variants, speech becomes tangential, overconfident, belligerent, or socially tone-deaf.

Messages are delivered with conviction, masking the cognitive disintegration beneath.

This can give the dangerous illusion of competence.
Moral reasoning flattens.

Nuanced ethical distinctions fade.

Complex dilemmas are simplified into win/lose or me/others scenarios, making destructive or unethical policies more likely to pass unchallenged.

If those who should challenge fear challenging, a dark mess unfolds.
Left unchecked, these cognitive and emotional deficits cascade.

Disinhibition combined with a lack of empathy, poor judgment and moral flattening inevitably leads to decision making that increasingly imperils not only the nation they rule, but global stability.
Institutions & advisors exist to mitigate human error.

FTD in leadership illustrates why cognitive health isn’t simply a private matter, it’s a societal one.

Checks on power are essential precisely because human brains fail. Are sufficient checks in place currently? I’d say not
Brilliance or charisma, if they ever existed in the first place, cannot compensate for frontal lobe dysfunction.

Without intervention, cognitive decline in leadership has direct, measurable consequences on policy, conflict, and most importantly, human lives.
Imagine a world leader who cannot resist impulsivity, cannot weigh moral cost, cannot foresee consequences, and cannot plan beyond immediate desires.

Every crisis inescapably becomes a mirror of their brain’s deficits; chaotic, destructive, impulsive, irrational, amoral.
FTD doesn’t erase history, but it erodes the ability to learn from it. Past mistakes barely even register, ultimately becoming irrelevant.

The leader drifts further from reality & so too do the people who rely on their judgment. Especially for those who hang on his every word.
In short, unchecked frontal lobe degeneration in leadership is not just a clinical problem, it is a seriously gargantuan geopolitical risk.

Cognitive decline in power, especially when invisible, or unchallenged (as it is here), can ripple across nations & generations.
Society assumes competence in its leaders (Trump an exception to this rule).

But FTD shatters that assumption quietly at first, then catastrophically. It is insidious by nature.

Vigilance, accountability, and structural checks exist precisely because the human brain is fallible
This process is unfolding in someone with control over armies, nuclear weapons, economic systems, and international diplomacy

The neurological degeneration of a few cubic centimeters of cortex has already become a global risk factor.

And it will continue to worsen.
If you read this thread and thought to yourself “this is worrying, I’m seeing a lot of this kind of behaviour in friends, family and co-workers”

Then no, they’re not all developing FTD. They’re just suffering from good old frontal lobe dysfunction.

Why? COVID infections.

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More from @JamesThrot

Mar 3
When you realise that frontal lobe dysfunction lowers resistance to manipulation & propaganda

And that aging leads to frontal decline, affecting how seniors vote

You’ll understand why the uncontrolled spread of a virus, well documented to damage the frontal lobes, is encouraged
Why?

Reduced prefrontal cortical function, whether from injury, aging or temp impairment, is associated with decreased critical evaluation, increased impulsivity & greater reliance on emotionally salient narratives, which can increase vulnerability to manipulation & propaganda.
A society’s resistance to propaganda depends on the cognitive health of its population.

If executive function declines at scale, you end up with worse decisions on an individual basis, and weaker collective judgment.

And SARS-CoV-2 is the virus that corrodes executive function.
Read 6 tweets
Feb 27
We are being gaslit into believing that the impulsivity, cruelty & polarisation we are seeing is purely cultural & political.

That explanation is psychologically comforting, but inaccurate.

It means we don't have to examine biology.

But we must.

COVID has entered the chat 🧵
The pretrontal cortex, particularly dorsolateral & orbitofrontal regions, is the regulatory governor of human behaviour.

It exerts top-down control over limbic threat circuitry.

It suppresses impulses before they become actions.

It filters speech before it leaves your mouth.
This is the system that allows you to

Pause.
Reconsider.
Anticipate consequences.
Inhibit bias.
Tolerate ambiguity.
De-escalate when provoked.

Remove or weaken that system and behaviour changes reliably.
Read 15 tweets
Feb 24
We need to have serious conversations about what COVID is doing to people’s brains, minds, behaviour & personalities.

But it is impossible to do so when people either refuse to acknowledge reality, or those who do acknowledge it tell us we can’t discuss it because it’s “ableist”
Throwing around accusations of ableism is a smokescreen. A way to avoid confronting how a mass-infecting, brain-damaging virus may be reshaping behaviour at scale.

Studies have found post-COVID changes in brain metabolism, grey matter, attention & emotional processing. FACT.
If a virus impairs the neural circuits responsible for empathy, inhibition & moral judgment, society as a whole becomes more susceptible to extremism, selfishness, cruelty & authoritarian propaganda.

This is scientifically & neurologically accurate.

Don’t like it? Tough shit.
Read 7 tweets
Feb 22
People don’t “pretend” everything is fine.

They adapt to dysfunction. This becomes the new “normal”.

The human mind will tolerate astonishing levels of decline if it happens slowly & collectively.

There is not going to be a “reckoning”. Just a slow, gradual, painful collapse.
The most effective way to normalise decline is to make sure everyone declines together.

Collective deterioration is socially self-sealing. If everyone’s diminished, no one feels uniquely diminished.

You’d only notice if observing from outside.

i.e. the ones avoiding infection.
The QT asked “Aren’t they tired?”

Yes, they’re tired. Some exhausted. Some burnt out.

They just won’t trace the line between cause & consequence. It’s easier to live with exhaustion than to admit it wasn’t inevitable.

What you’re witnessing here is Shifting Baseline Syndrome.
Read 4 tweets
Feb 16
If you found out a music concert was going to secretly release a noxious gas to subtly harm the attendees, would you just don a gas mask & attend anyway? You’d be safe. They wouldn’t.

Would this impact your enjoyment? Or would you feel uneasy being surrounded by potential harm?
Attending a crowded indoor event masked is like joining an event secretly exposing everyone else to a mild toxin.

You may be safe, but you’re legitimising harm.

These events spike community infections, making hospitals, children, and vulnerable people more at risk.
Claiming to take COVID seriously, while partaking in such events is blatant hypocrisy.

Masking doesn’t absolve you of the consequences you help create. Children, the immunocompromised, and your community still pay the price of these super spreader events.
Read 9 tweets
Jan 8
Has police & military behaviour become harsher, more rigid & more escalation-prone since 2020?

This isn’t just about politics or “bad apples”.

There’s a deeper, biological factor being ignored…

SARS-CoV-2

I’m a neurologist, and I’ll explain what’s going on here 🧵.
It’s common knowledge that both policing and the military already over select for people with certain traits:

- high threat sensitivity
- comfort with hierarchy
- rule based cognition
- obedience over ambiguity
- identity anchored in authority

This was true long before COVID.
What historically prevented this from becoming outright dangerous at scale was intact frontal lobe function.

The frontal cortex supplies inhibition, proportionality, empathy under stress, moral updating & the ability to back down.

And COVID is proven to damage the frontal lobes
Read 17 tweets

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